JPM21: UHS details impact of fall cyberattack on patient volumes as COVID-19 could impact payer mix

A major cyberattack this fall on its computer systems led to a decline in volume for Universal Health Services, but the system does not expect any lingering effects, a system leader said Monday during the annual J.P. Morgan healthcare conference.

The 26-hospital system did not specify the financial impact of the attack that forced the outage of UHS’ hospital computer and telephone systems in late September. UHS leadership did detail the impact of changes to the system’s payer mix due to the pandemic.

“One of the challenges … you know we are reliant on our IT but don’t realize how much you are until someone disrupts that,” said Steve Filton, UHS’ chief financial officer, during the virtual event.

UHS is doing a precise calculation on how much the outage cost the system, but “we were delayed in our billing and coding and catching up with all of those things,” Filton said.

The system saw a decline in some of its volumes related to non-COVID-19 care as some ambulance drivers didn’t want to go to hospitals that had a manual admission process. The same goes for surgeons that decided to go to hospitals for procedures to avoid a manual process, Filton said.

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By the end of November, UHS, like other systems, was experiencing a renewed wave of COVID-19 after the holidays and winter weather pushed for more indoor gatherings.

The system has canceled some elective surgeries on a day-to-day basis, Filton said.

“We are pretty optimistic that once the holidays have passed, as they have, and people get back to more rational social distancing and behavior and certainly as vaccine more widely administered, we will see less of an impact as the year goes on,” Filton said.

He expects the second half of 2021 to look more like 2019 before the pandemic in terms of patient volume levels.

However, it remains unclear how other effects from the pandemic are felt, namely a change to the system’s payer mix as commercial insurance declines due to COVID-19 job losses and enrollment swells in lower-paying government programs like Medicaid.

Filton said UHS is not seeing a dramatic decline in its payer mix. “Over time I think we will see more of that as unemployment remains at an elevated level,” he said.

The pandemic has affected volume much more than the payer mix, he added.

There may be some other factors that could lessen the blow of a payer mix change; chief among them is that some large employers in UHS markets decided to furlough workers that preserve health insurance benefits.

“One of the things we will look for is revenue per admission will decline in 2021 as compared to 2019 because some of this acuity will stay in place,” Filton said. “It would be disingenuous of us to think there wouldn’t be some impact from high unemployment but [it] tends to happen over an extended period of time.”

UHS generated $241.2 million in profits for the third quarter of the year, the system’s latest earnings report said.

Filton also gave a quick update on the system’s compliance with a price transparency rule that requires hospitals to post payer-negotiated rates for certain shoppable services starting Jan. 1.

He said UHS is in compliance with the rule but questions whether it will lead to a major increase in consumers shopping among hospitals for the best price.

“I don’t think people shop for healthcare the way they shop for a car,” he said.